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West Virginia Income Maintenance Manual Chapter 13

West Virginia Income Maintenance Manual Page 32 Chapter 13 Determining Disability, Incapacity, and Blindness

• If the medical reports and social summary are with the MRT at the same time the above action is taken, the Worker notifies the MRT using form DFA-RT-2. If the case was referred for a blindness decision, the DFA-RT-2 must indicate whether or not a decision about blindness is still needed. 13.9.3 PROCEDURE WHEN DISABILITY IS DISALLOWED BY THE SSA PRIOR TO MEDICAID APPLICATION When the Worker learns that the applicant has previously applied for SSI and/or RSDI and that his claim was denied by the SSA on the basis that the client was not disabled, the procedures are as follows: • If the client states that there has been no deterioration in his condition since the SSA decision, and social information supports his statement, the application cannot be approved based on disability. • If the client's statement and/or social information indicates that there has been a deterioration in his condition, the Worker: o Begins the process of obtaining medical reports, completing the Social Summary Outline (DFA-RT-1) and the DFA-RT-2, and sending the packet to the MRT. The hand-written form is acceptable only when an electronic version is unavailable. The DFA-RT-1 must include a clear explanation of the reason the client and/or the Worker believe that there has been a deterioration in his physical and/or mental condition. o Refers the client to the SSA for reevaluation or reconsideration of his eligibility for SSI or RSDI. See Chapter 8, Resource Development. o Approves the application if a referral to the SSA for reevaluation is not required, and the client is found to be disabled or blind by the MRT. o Follows the procedures used when a claim is pending a final SSA decision, if a referral is made to the SSA for reevaluation.